## _cr1030

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---

### Overview
- PRSP builds on the Interim Strategy for Poverty Reduction (I-PRSP) presented to IDA and IMF Boards in April 2008.
- PRSP covers strategy for growth and poverty reduction for the period 2009-2011 and is coupled with a Plan of Priority Actions (PAP) detailing pluri-annual planning of actions, programs and measures.
- Ultimate objective: achieve effective and sustainable improvement of people’s living conditions by addressing the principal causes of poverty.
- Implementation under the I-PRSP produced results below expectations due to external shocks: hike in oil and food prices, severe flooding in 2008, and the global recession in 2009.
- PRSP strategy aims to promote sustainable growth, strengthen social consensus, and entrench principles of good governance.
- PRSP organized around four strategic pillars:
  - (i) strengthening of governance;
  - (ii) consolidation of the bases for strong and sustained growth;
  - (iii) development of human capital;
  - (iv) reduction of regional imbalances and promotion of community development.
- Cross-cutting themes: environment, HIV/AIDS, gender and human rights.
- Staffs note capacity and resource constraints and recommend prioritization of reforms for effective implementation.
- Preparation was generally inclusive: participation of private sector, religious groups, non-government organizations, National Assembly, technical and financial partners, and development partners including World Bank and IMF.
- Three main levels of consultation: (i) drafting and adoption of the road map of the process; (ii) diagnostic phase; (iii) final drafting of the PRSP.
- Staffs recommend continuing effective involvement of all actors during implementation.

### Poverty trends and diagnostics
- Poverty analysis based on QUIBB survey conducted in 2006 and does not reflect shocks in 2007 and 2008.
- Key statistics:
  - GDP per capita fell by 1.4 and 0.8 percent in 2007 and 2008, respectively.
  - Incidence of poverty: 74.3 percent in the rural areas and 36.7 percent in the urban areas (2006 QUIBB survey).
- Findings:
  - Strategy presents comprehensive cross-country poverty analysis but does not assess evolution of poverty over time.
- Staff recommendations:
  - Enhanced monitoring of poverty and filling information gaps on recent poverty trends; an updated survey is recommended to provide more accurate information on regional poverty and inequality.
  - Strengthen capacity to monitor and analyze poverty determinants and outcomes.
  - Closely monitor poverty reduction expenditures enabled by introduction of the functional classification of budget expenditures in the 2009 budget.
  - Publish regular reports on expenditure in priority sectors and conduct assessments of pro-poor measures and their impact.
- MDG assessment (second national MDG monitoring report approved in December 2008):
  - At current pace and with sustained efforts, only two MDGs can be reached:
    - (i) achieve universal primary education;
    - (ii) combat HIV/AIDS.
  - Areas unlikely to achieve MDGs by 2015: (i) eradicate extreme poverty, (ii) promote gender equality, (iii) reduce child mortality, (iv) improve maternal health, (v) ensure environmental sustainability.
- Staffs urge prioritizing management of population dynamics; recommended measures include satisfying unmet demand for family planning and accelerating demographic transition (e.g., educating girls, meeting contraceptive demand, and fighting discrimination against women).

### Macroeconomic policies and framework
- Staffs agree with the macroeconomic policy scenarios in the PRSP but emphasize regularly updating the macroeconomic framework given observed volatility and including updates in annual progress reports.
- Growth projections:
  - PRSP base scenario: real GDP growth of 1.7 percent in 2009 and 3.3 percent in 2010.
  - Staffs’ projections (accounting for global financial crisis and countercyclical policies): real GDP growth of 2.5 percent in 2009 and 2.6 percent in 2010.
  - Under both PRSP and staff projections, per capita GDP expected to begin to increase only modestly towards the end of the 2009-2011 period.
- Alternative scenario: substantial additional foreign aid linked to the United Nation’s Secretary General’s initiative for the MDGs in Africa; staffs note concerns about administrative and absorptive capacity and recommend acknowledging these concerns and including more detailed economic indicators under both scenarios.
- Fiscal and budget framework:
  - Medium-term budget framework links reform agenda and medium-term budget at aggregate level; targets a primary fiscal adjustment combined with increased external assistance and HIPC debt relief.
  - Authorities have taken recent actions towards a temporary relaxation in fiscal adjustment to stimulate economic activity; staffs consider these actions appropriate.
  - Macroeconomic framework uses prudent projections on tax revenue growth; primary fiscal balance targeted to reach 1 percent of GDP in 2011.
- Capacity and execution:
  - Capacity constraints have limited effectiveness of domestically financed investment spending; execution in 2009 seems substantially higher than in previous years.
- Current account and inflation:
  - Latest staffs projections indicate the current account deficit will remain high at 7 percent through 2009-2010.
  - PRSP framework expects a steady improvement of the current account deficit to 4.2 percent by 2010.
  - Inflation expected to stay between 2 and 3 percent in 2009-2010, aligned with WAEMU convergence criteria and BCEAO and staffs projections.
- Financial sector: staff projections suggest credit to the economy will recover only slowly given delays in restructuring of the banking sector.
- Staffs recommend including updated current account projections to reflect effects of the global recession and acknowledging absorptive capacity constraints under alternative aid scenarios.

### Sectoral policies

H3 A. Strengthening of Governance
- Progress noted in public finance management reforms introduced during I-PRSP:
  - incorporation of WAEMU directives in national legislation;
  - introduction of Integrated Public Finance Management System (SIGFIP);
  - abolition of exceptional expenditure execution procedures;
  - creation of the General Inspectorate of Finance and Control Auditors;
  - adoption of a strategy for clearance of domestic arrears.
- Remaining reforms needed:
  - improvements in predictability and monitoring of budget execution;
  - fiscal consolidation;
  - gradual introduction of Medium-Term Expenditure Frameworks (MTEFs) and program budgets;
  - improvements of internal and external controls;
  - strengthening of Treasury management including cash management to prevent new accumulation of domestic arrears;
  - effective implementation of domestic arrears clearance strategy.
- Public procurement action plan (based on PEMFAR report) measures:
  - (i) transposition of WAEMU directives on procurement into national legal framework;
  - (ii) adoption of procurement code to make procurement arrangements more transparent and less centralized;
  - (iii) drafting of implementing texts describing procurement procedures;
  - (iv) drafting of a handbook of procedures;
  - (v) adoption of arrangements to ensure strict expenditure monitoring.
- Staffs recommend inclusion of a timeline for procurement reforms, finalization of a calendar for reforms, and identification of output and outcome indicators to monitor implementation.

H3 B. Promoting Strong and Sustained Growth

Improving the Business Environment
- Current business environment described as difficult for investors and private operators.
- Proposed reforms: creation of a one-stop shop with effective delegation of approval by several administrative departments, revitalizing the industrial free trade zone, reducing cost of and increasing access to credit.
- Staffs note limited implementation details and recommend identifying detailed and prioritized reforms addressing labor market, investor protection legislation, taxation, and costs of factors such as energy and telecommunications.
- Revision of the Investment Code is recommended as forum to discuss key issues; strengthening the judicial system is necessary.

Increase Agricultural Productivity
- Agriculture recognized as critical for growth and poverty reduction, with higher poverty incidence in rural areas.
- Focus on food and export crop production; additional attention needed to livestock and fishing.
- Staff recommendations:
  - Detail measures on legal and institutional framework, land tenure, rural sector structure (producer associations, regional chambers of agriculture), access to productive resources and markets including financing, environment preservation, and capacity strengthening.
  - Rapid implementation of National Food Security Plan to reduce vulnerability to natural disasters.
- Cotton sector (SOTOCO) recommendations:
  - Conduct a human resources audit for SOTOCO and implement audit recommendations regarding labor force size.
  - Modernize SOTOCO’s accounting system to improve transparency and efficient mobilization of resources for timely provision of inputs to producers.
  - Develop an effective inter-profession allowing producers an active role in sector management and implement a capacity-building program for stakeholders.

Boost Natural Resources Extraction
- Phosphates industry issues: lack of maintenance and renewal of equipment, poor management and electricity shortages, reduced operating capacity and weak performance.
- Staffs recommend:
  - preparing a clear strategic vision for the sector and conducting a strategic and financial audit;
  - specifying an investment program for restoring and boosting production capacity in the medium term;
  - swift revision of the Mining Code;
  - full adoption of EITI principles to enhance sector transparency and governance.

Development of Infrastructure
- Strategy assesses infrastructure weaknesses candidly; ambitious rehabilitation plan for roads and bridges will need support from a viable and well-managed road maintenance fund.
- Energy sector reforms include diversification of sources, reduction of costs, and institutional and regulatory reform.
- Staffs recommend preparation of an articulated and integrated infrastructure plan.
- For the energy sector, distinguish between short-term steps to improve energy supply and long-term reforms and actions (investments, new sources of imports, pricing and demand management).

H3 C. Human Capital Development
- Education sector strategy prioritizes MDG of universal primary completion; built on Country Status Report (RESEN) and a financial simulation model.
- PRSP education strategy is consistent with national education strategy as described in the Letter for Education Policy Development.
- Discrepancies exist between the PAP of the PRSP and the Education Sector Plan (ESP) and should be addressed.
- Staffs urge sectoral committee of the PSRP for education be the same as the Coordination Committee of the education sector plan to ensure consistency in monitoring and evaluation.
- Staffs urge the three Ministries in charge of education to initiate ESP implementation, including organizing coordination, monitoring and evaluation structures (Comité inter-ministériel de pilotage, Comité de coordination and Secrétariat Technique Permanent) and strengthening the project coordination unit.
- Staffs recommend attention to preparation and implementation of capacity-building/skills transfer program accompanying ESP project implementation and encourage communication activities on the ESP.

### Health access, outcomes, and public health subsidies
- Findings:
  - Some progress in immunization coverage, availability and use of treated mosquito netting, maternal and child health, and coverage of serious malaria cases in children.
  - Functional infrastructure has not improved; health facilities are poorly equipped and ill suited, especially in rural areas.
  - Distribution of public health subsidies is not pro-poor.
  - The poorest 50 percent receives 20 percent of the subsidies to teaching hospitals and 30 percent of the subsidies to hospitals and health centers.
  - The conclusion on distributional issues is based on analysis of the 2006 QUIBB survey.
- Staff recommendations:
  - Strengthen pro-poor policies by:
    - Increasing access to health infrastructure in the rural areas.
    - Training and deploying health personnel to rural areas.
    - Financing provision of services to address diseases that have the most impact on the poor.
    - Better targeting of public health subsidies.
  - Develop a social protection strategy for Togo to:
    - Broaden the current narrow and fragmented understanding of social protection.
    - Identify key building blocks of sound social protection (e.g., targeting; delivery mechanisms; need for sustainability).
    - Ensure future national systems draw on pilot activities underway.
    - Define the role of non-state actors in the provision of social protection and how this might be best supported.
    - Assess the opportunity and efficacy of specific safety net transfers systems defined as non-contributory transfer programs targeted to the poor and the vulnerable.

### Reduction of regional imbalances and community development (Pillar IV)
- Findings:
  - Addition of Pillar IV improves strategy to address poverty reduction, access to basic services, decentralization, and empowerment of local communities.
  - Strategy could be refined by clearly identifying government options for addressing regional imbalances, inter-sectoral dialogue and coordination, the decentralization agenda, and governance and management issues.
  - Ongoing pilot projects in local development (financed by development partners including the European Union, the UNDP, and the World Bank) are important examples for future activities.
  - Current Pillar IV approach includes creating a (central) agency implementing subprojects and a fund to finance community development, which runs against principle of effective decentralization and delegation of authority to regional and local bodies.
  - Example: World Bank financed the PDC (Community Development Program) project with its five highly autonomous and independent agencies, which could serve as pilots.
- Staff recommendations:
  - Advance the decentralization framework to effectively engage local governments in community development.
  - Capitalize on experiences from ongoing projects as pilots to develop future systems and implementing structures.

### Implementation, monitoring and evaluation (M&E), and implementation risks
- Institutional framework:
  - PRSP institutional framework follows I-PRSP structure and includes:
    - National Council on Development Policy and Poverty Reduction (chaired by the Prime Minister and including representatives of all branches of government and non-government stakeholders).
    - Interministerial Committee on Poverty Reduction Strategies.
    - Technical Steering Committee.
    - Permanent Technical Secretariat.
    - Sectoral Committees.
    - Regional and Local Committees.
  - Preliminary lessons from the I-PRSP point to difficulties due to redundancies, lack of clarity in division of labor, and limited capacity of civil society to fully engage.
- Staff recommendations on institutional arrangements:
  - Streamline the oversight structure while ensuring adequate involvement of all stakeholders.
  - Clarify responsibilities of each entity.
  - Strengthen civil society capacity.
- Monitoring and evaluation:
  - PRSP is elaborated on a results-based framework, but does not explicitly link actions to achievement of goals.
  - PAP presents a wide range of output and outcome indicators that could benefit from streamlining given M&E limitations.
- Staff recommendations on M&E:
  - Further link objectives to actions articulated around outcome indicators as part of PRSP implementation.
  - Focus on a smaller number of critical results and monitorable indicators with baseline and target values, based on adequacy and availability, consistency with objectives, and appropriateness given the country's institutional capacity.
  - Strengthen national statistics systems to produce timely data to inform policy makers.
- Implementation risks and mitigation priorities:
  - Significant risks from capacity constraints, political tensions, and adverse economic and natural disaster shocks.
  - Specific risks include relatively weak administrative capacity, vulnerability to external shocks, and the possibility that elections in early 2010 may stall the reform agenda.
  - Success in the following efforts could mitigate risks:
    - (i) improve governance and build capacity, especially in public finance management, to increase efficiency, effectiveness and transparency of public resources;
    - (ii) coordinate closely with donors to ensure sufficient technical and financial assistance;
    - (iii) deepen analysis to support and inform policies;
    - (iv) continue working towards political unity; and
    - (v) strengthen the integration of natural disaster management in development programs.

### Conclusions and issues for discussion
- Overall assessment:
  - PRSP clearly identifies the binding obstacles to poverty reduction in Togo and outlines an adequate framework for implementing the Government’s growth and poverty reduction agenda over the period 2009-2011.
  - Current capacity constraints require prioritization of reform efforts.
  - Document recognizes considerable challenges to achieve the MDGs and the risks to PRSP implementation and outlines the institutional framework required for implementation and M&E.
- Key challenges for authorities:
  - Maintain an appropriate up-to-date macroeconomic framework that takes into account the country’s macroeconomic and fiscal risks; importance emphasized given that Togo is a small open economy vulnerable to external shocks.
  - Translate key priorities identified in the PRSP into concrete and adequately costed expenditure plans that balance development needs and macroeconomic risks.
  - Improve access to social services in line with expectations of an expansion of public service delivery, supported by improved targeting and enhanced public expenditure efficiency, together with safety nets for the most vulnerable population.
- Decision point:
  - Executive Directors’ views are sought on whether they agree with the main areas identified by staffs as priorities for strengthening the strategy and its implementation, and areas identified as key implementation risks.

*Source: _cr1030 - 22. Staffs agree with the strategy to increase access to health care services and urge the*

### 1. The Poverty Reduction Strategy Paper (PRSP) for Togo builds on the strategy laid

### _cr1030 - 1. The Poverty Reduction Strategy Paper (PRSP) for Togo builds on the strategy laid

### Overview
- PRSP builds on the Interim Strategy for Poverty Reduction (I-PRSP) presented to IDA and IMF Boards in April 2008.
- PRSP covers strategy for growth and poverty reduction for the period 2009-2011 and is coupled with a Plan of Priority Actions (PAP) detailing pluri-annual planning of actions, programs and measures.
- Ultimate objective: achieve effective and sustainable improvement of people’s living conditions by addressing the principal causes of poverty.
- Implementation under the I-PRSP produced results below expectations due to external shocks: hike in oil and food prices, severe flooding in 2008, and the global recession in 2009.
- PRSP strategy aims to promote sustainable growth, strengthen social consensus, and entrench principles of good governance.
- PRSP is organized around four strategic pillars:
  - (i) strengthening of governance;
  - (ii) consolidation of the bases for strong and sustained growth;
  - (iii) development of human capital;
  - (iv) reduction of regional imbalances and promotion of community development.
- Cross-cutting themes: environment, HIV/AIDS, gender and human rights.
- Staffs note capacity and resource constraints and recommend prioritization of reforms for effective implementation.
- Preparation was generally inclusive: participation of private sector, religious groups, non-government organizations, National Assembly, technical and financial partners, and development partners including World Bank and IMF.
- Three main levels of consultation: (i) drafting and adoption of the road map of the process; (ii) diagnostic phase; (iii) final drafting of the PRSP.
- Staffs recommend continuing effective involvement of all actors during implementation.

### Poverty trends and diagnostics
- Poverty analysis is thorough but somewhat overtaken by events; based on QUIBB survey conducted in 2006 and thus does not reflect shocks in 2007 and 2008.
- GDP per capita fell by 1.4 and 0.8 percent in 2007 and 2008, respectively.
- Strategy presents comprehensive cross-country poverty analysis but does not assess evolution of poverty over time.
- Staffs recommend enhanced monitoring of poverty and filling information gaps on recent poverty trends; an updated survey is recommended to provide more accurate information on regional poverty and inequality.
- Staffs urge strengthening capacity to monitor and analyze poverty determinants and outcomes.
- Staffs recommend close monitoring of poverty reduction expenditures enabled by the introduction of the functional classification of budget expenditures in the 2009 budget.
- Staffs recommend publication of regular reports on expenditure in priority sectors and conducting assessments of pro-poor measures and their impact.
- PRSP acknowledges challenges to achieve the MDGs; second national MDG monitoring report approved in December 2008 concludes that, at current pace and with sustained efforts, only two MDGs can be reached:
  - (i) achieve universal primary education;
  - (ii) combat HIV/AIDS.
- Areas unlikely to achieve MDGs by 2015: (i) eradicate extreme poverty, (ii) promote gender equality, (iii) reduce child mortality, (iv) improve maternal health, (v) ensure environmental sustainability.
- Staffs urge Government to make management of population dynamics a priority goal given rapid population growth impacts; recommended measures include satisfying unmet demand for family planning and accelerating demographic transition (e.g., educating girls, meeting contraceptive demand, and fighting discrimination against women).
- These measures would also help progress toward MDGs such as universal primary education, lower maternal mortality rates, gender equality and women empowerment, and lower child mortality rates.

### Macroeconomic policies and framework
- Staffs agree with the macroeconomic policy scenarios in the PRSP but emphasize regularly updating the macroeconomic framework given observed volatility and including updates in annual progress reports.
- PRSP base scenario projects real GDP growth of 1.7 percent in 2009 and 3.3 percent in 2010.
- Staffs’ projections (accounting for global financial crisis and countercyclical policies) expect real GDP growth of 2.5 percent in 2009 and 2.6 percent in 2010.
- Under both PRSP and staff projections, per capita GDP is expected to begin to increase only modestly towards the end of the 2009-2011 period.
- PRSP includes an alternative scenario based on substantial additional foreign aid linked to the United Nation’s Secretary General’s initiative for the MDGs in Africa; staffs note concerns about administrative and absorptive capacity and recommend acknowledging these concerns and including more detailed economic indicators under both scenarios.
- Medium-term budget framework links reform agenda and medium-term budget at aggregate level; targets a primary fiscal adjustment combined with increased external assistance and HIPC debt relief.
- Authorities have taken recent actions towards a temporary relaxation in fiscal adjustment to stimulate economic activity by boosting investment in infrastructure and social sectors given observed growth rates well below potential and impact of global recession; staffs consider these actions appropriate.
- Macroeconomic framework uses prudent projections on tax revenue growth; primary fiscal balance is targeted to reach 1 percent of GDP in 2011.
- Capacity constraints have limited effectiveness of domestically financed investment spending; authorities are addressing administrative constraints and execution in 2009 seems substantially higher than in previous years.
- Current account projections need updating to reflect the effects of the global recession:
  - Latest staffs projections indicate the current account deficit will remain high at 7 percent through 2009-2010.
  - PRSP framework expects a steady improvement of the current account deficit to 4.2 percent by 2010.
- Inflation projections in PRSP are reasonable and aligned with WAEMU convergence criteria; deceleration expected after 2008 spike linked to world fuel and food prices.
  - Inflation is expected to stay between 2 and 3 percent in 2009-2010, in line with BCEAO and staffs projections.
- Staff projections suggest credit to the economy will recover only slowly given delays in restructuring of the banking sector.

### Sectoral policies

A. Strengthening of Governance
- Recent improvements in public finance management welcomed; continuing efforts critical for transparency, efficiency and accountability.
- Reforms during I-PRSP implementation include incorporation of WAEMU directives in national legislation, introduction of Integrated Public Finance Management System (SIGFIP), abolition of exceptional expenditure execution procedures, creation of the General Inspectorate of Finance and Control Auditors, and adoption of a strategy for clearance of domestic arrears.
- Remaining reforms needed: improvements in predictability and monitoring of budget execution, fiscal consolidation, gradual introduction of Medium-Term Expenditure Frameworks (MTEFs) and program budgets, improvements of internal and external controls, strengthening of Treasury management including cash management to prevent new accumulation of domestic arrears, and effective implementation of domestic arrears clearance strategy.
- Staffs agree with proposed reforms and encourage swift pursuit.
- Public procurement action plan (based on PEMFAR report) measures include:
  - (i) transposition of WAEMU directives on procurement into national legal framework;
  - (ii) adoption of procurement code to make procurement arrangements more transparent and less centralized;
  - (iii) drafting of implementing texts describing procurement procedures;
  - (iv) drafting of a handbook of procedures;
  - (v) adoption of arrangements to ensure strict expenditure monitoring.
- Staffs recommend inclusion of a timeline for procurement reforms, finalization of a calendar for reforms, and identification of output and outcome indicators to monitor implementation.

B. Promoting Strong and Sustained Growth
- PRSP emphasizes creating new foundations for stronger and sustained growth and pursuing reforms in multiple areas.

Improving the Business Environment
- Current business environment is difficult for investors and private operators.
- Proposed reforms: creation of a one-stop shop with effective delegation of approval by several administrative departments, revitalizing the industrial free trade zone, reducing cost of and increasing access to credit.
- Staffs note limited implementation details and recommend identifying detailed and prioritized reforms addressing labor market, investor protection legislation, taxation, and costs of factors such as energy and telecommunications.
- Revision of the Investment Code is recommended as forum to discuss key issues; strengthening the judicial system is necessary.

Increase Agricultural Productivity
- Strategy recognizes agriculture’s importance for growth and poverty reduction, especially given higher poverty incidence in rural areas.
- Focus on food and export crop production; more attention needed to livestock and fishing sectors.
- Staffs recommend further detailing measures on legal and institutional framework, land tenure, rural sector structure (producer associations, regional chambers of agriculture), access to productive resources and markets including financing, environment preservation, and capacity strengthening.
- Government committed to implement National Food Security Plan; staffs emphasize rapid implementation to reduce population vulnerability to natural disasters.
- For cotton sector (SOTOCO):
  - Staffs recommend a human resources audit for SOTOCO and implementation of audit recommendations regarding labor force size.
  - Recommend modernization of SOTOCO’s accounting system to improve transparency and efficient mobilization of resources for timely provision of inputs to producers.
  - Development of an effective inter-profession allowing producers active role in sector management is critical; capacity-building program for stakeholders required.

Boost Natural Resources Extraction
- Phosphates industry has suffered from lack of maintenance and renewal of equipment, poor management and electricity shortages, causing reduced operating capacity and weak performance.
- Increasing production requires significant improvements in managerial, technical and technological capability, human resources, and environmental management skills.
- Staffs stress the importance of preparing a clear strategic vision for the sector; recommend a strategic and financial audit as an important input.
- Sector strategy should specify the critical role of investment program for restoring and boosting production capacity in the medium term.
- PRSP recognizes weaknesses in the Mining Code; staffs urge swift revision.
- Staffs recommend full adoption of EITI principles to enhance sector transparency and governance.

Development of Infrastructure
- Strategy candidly assesses infrastructure weaknesses and impact on the economy.
- Ambitious rehabilitation plan for roads and bridges will need support from a viable and well-managed road maintenance fund.
- Energy sector reforms include diversification of sources, reduction of costs, and institutional and regulatory reform.
- Staffs recommend preparation of an articulated and integrated infrastructure plan.
- For energy sector, staffs recommend distinguishing between short-term steps to improve energy supply and long-term reforms and actions (investments, new sources of imports, pricing and demand management).

C. Human Capital Development
- Education sector strategy is ambitious yet realistic, prioritizing MDG of universal primary completion; built on Country Status Report (RESEN) and a financial simulation model.
- PRSP education strategy is consistent with national education strategy as described in the Letter for Education Policy Development.
- Discrepancies exist between the PAP of the PRSP and the Education Sector Plan (ESP) which should be addressed.
- Staffs urge that the sectoral committee of the PSRP for education be the same as the Coordination Committee of the education sector plan to ensure consistency in monitoring and evaluation.
- Staffs urge the three Ministries in charge of education to initiate ESP implementation, including organizing the set-up of coordination, monitoring and evaluation structures (Comité inter-ministériel de pilotage, Comité de coordination and Secrétariat Technique Permanent) and strengthening the project coordination unit.
- Staffs recommend particular attention to preparation and implementation of capacity-building/skills transfer program accompanying ESP project implementation and encourage communication activities on the ESP.

*IMF staff report text as provided in the source content.*

### 22. Staffs agree with the strategy to increase access to health care services and urge the

### _cr1030 - 22. Staffs agree with the strategy to increase access to health care services and urge the

### Health access, outcomes, and public health subsidies
- Findings:
  - Some progress has been made in immunization coverage, availability and use of treated mosquito netting, maternal and child health, and coverage of serious malaria cases in children.
  - Functional infrastructure has not improved; health facilities are poorly equipped and ill suited, especially in rural areas where the incidence of poverty is higher.
  - The distribution of public health subsidies is not pro- poor.
  - The poorest 50 percent receives 20 percent of the subsidies to teaching hospitals and 30 percent of the subsidies to hospitals and health centers.
  - The incidence of poverty is 74.3 percent in the rural areas and 36.7 percent in the urban areas, according to the 2006 QUIBB survey.
  - The conclusion on distributional issues is based on analysis of the 2006 QUIBB survey.

- Staff recommendations:
  - Strengthen pro-poor policies by:
    - Increasing access to health infrastructure in the rural areas.
    - Training and deploying health personnel to rural areas.
    - Financing the provision of services to address diseases that have the most impact on the poor.
    - Better targeting of public health subsidies.
  - Develop a social protection strategy for Togo to:
    - Broaden the current narrow and fragmented understanding of social protection.
    - Identify key building blocks of sound social protection (e.g., targeting; delivery mechanisms; need for sustainability).
    - Ensure future national systems draw on pilot activities underway.
    - Define the role of non-state actors in the provision of social protection and how this might be best supported.
    - Assess the opportunity and efficacy of specific safety net transfers systems defined as non-contributory transfer programs targeted to the poor and the vulnerable.

### Reduction of regional imbalances and community development (Pillar IV)
- Findings:
  - Addition of Pillar IV improves the strategy to address poverty reduction, access to basic services, decentralization, and empowerment of local communities.
  - The strategy could be refined by clearly identifying government options for addressing regional imbalances, issues and challenges of inter-sectoral dialogue and coordination, the decentralization agenda, and governance and management issues.
  - Ongoing pilot projects in local development (financed by development partners including the European Union, the UNDP, and the World Bank) can be considered important examples for future activities.
  - The current Pillar IV approach includes creating a (central) agency implementing subprojects and a fund to finance community development, which runs against the principle of effective decentralization and delegation of authority to regional and local bodies.
  - Example: World Bank financed the PDC (Community Development Program) project with its five highly autonomous and independent agencies, which could serve as pilots.

- Staff recommendations:
  - Advance the decentralization framework to effectively engage local governments in community development.
  - Capitalize on experiences from ongoing projects as pilots to develop future systems and implementing structures.

### Implementation, monitoring and evaluation (M&E), and implementation risks
- Institutional framework and governance:
  - The PRSP institutional framework follows the I-PRSP structure and includes:
    - National Council on Development Policy and Poverty Reduction (chaired by the Prime Minister and including representatives of all branches of government and non-government stakeholders).
    - Interministerial Committee on Poverty Reduction Strategies.
    - Technical Steering Committee.
    - Permanent Technical Secretariat.
    - Sectoral Committees.
    - Regional and Local Committees.
  - Preliminary lessons from the I-PRSP point to difficulties due to redundancies, lack of clarity in division of labor, and limited capacity of civil society to fully engage.

- Staff recommendations on institutional arrangements:
  - Streamline the oversight structure while ensuring adequate involvement of all stakeholders.
  - Clarify responsibilities of each entity.
  - Strengthen civil society capacity.

- Monitoring and evaluation:
  - The PRSP is elaborated on a results-based framework, but does not explicitly link actions to achievement of goals.
  - The PAP presents a wide range of output and outcome indicators that could benefit from streamlining given M&E limitations.

- Staff recommendations on M&E:
  - Further link objectives to actions articulated around outcome indicators as part of PRSP implementation.
  - Focus on a smaller number of critical results and monitorable indicators with baseline and target values, based on adequacy and availability, consistency with objectives, and appropriateness given the country's institutional capacity.
  - Strengthen national statistics systems to produce timely data to inform policy makers.

- Implementation risks and mitigation priorities:
  - Significant risks remain from capacity constraints, political tensions, and adverse economic and natural disaster shocks.
  - Specific risks include relatively weak administrative capacity, vulnerability to external shocks, and the possibility that elections in early 2010 may stall the reform agenda.
  - Success in the following efforts could mitigate risks:
    - (i) improve governance and build capacity, especially in public finance management, to increase efficiency, effectiveness and transparency of public resources;
    - (ii) coordinate closely with donors to ensure sufficient technical and financial assistance;
    - (iii) deepen analysis to support and inform policies;
    - (iv) continue working towards political unity; and
    - (v) strengthen the integration of natural disaster management in development programs.

### Conclusions and issues for discussion
- Overall assessment:
  - The PRSP clearly identifies the binding obstacles to poverty reduction in Togo and outlines an adequate framework for implementing the Government’s growth and poverty reduction agenda over the period 2009-2011.
  - Current capacity constraints require prioritization of reform efforts.
  - The document recognizes the considerable challenges to achieve the MDGs and the risks to PRSP implementation and outlines the institutional framework required for implementation and M&E.

- Key challenges for authorities as they sharpen strategic focus and strengthen PRSP implementation:
  - Maintaining an appropriate up-to-date macroeconomic framework that takes into account the country’s macroeconomic and fiscal risks; importance emphasized given that Togo is a small open economy vulnerable to external shocks.
  - Translating key priorities identified in the PRSP into concrete and adequately costed expenditure plans that balance development needs and macroeconomic risks.
  - Improving access to social services in line with expectations of an expansion of public service delivery, supported by improved targeting and enhanced public expenditure efficiency, together with safety nets for the most vulnerable population.

- Decision point:
  - Executive Directors’ views are sought on whether they agree with the main areas identified by staffs as priorities for strengthening the strategy and its implementation, and areas identified as key implementation risks.

*Source: _cr1030 - 22. Staffs agree with the strategy to increase access to health care services and urge the*

---


_Source: https://www.imf.org/-/media/websites/imf/imported-full-text-pdf/external/pubs/ft/scr/2010/_cr1030.pdf_